Individual
LACEY BUCHHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 W WASHINGTON ST, AUGUSTA, WI 54722-9085
(715) 286-2488
Mailing address
708 W WASHINGTON ST, AUGUSTA, WI 54722-9085
(715) 286-2488
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2212-19
WI
Other
Enumeration date
12/16/2014
Last updated
03/26/2020
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